DESCRIPTION: The Wills Eye Health System proposes to establish a multidisciplinary Wills Eye Translational Research Center (the WETRC) in response to the DHHS/CDC RFA-DP- 10-004. The WETRC will conduct the project entitled, Overcoming Barriers in Vision Care Utilization of African Americans with Diabetes. According to the American Academy of Ophthalmology and the American Diabetes Association, annual dilated fundus examinations (DFEs) are recommended for all people with diabetes to reduce their risk of vision loss. Despite this fact, only 50% to 60% of adults with diabetes follow this recommendation, and African Americans are less likely to see an eye doctor or get a DFE compared to Caucasians. Therefore, the goal of the WETRC is to enhance the eye care of underserved, African Americans in Philadelphia with diabetes, improve the population-based quality of eye care services and close the gap between optimal evidence-based eye care and existing practice. The WETRC specific studies (AIMS) are to: 1) Develop a retrospective analysis of existing ophthalmic data sets to assess and evaluate individual-level and system-level factors that impact access to and quality of vision care in patients with diabetes; 2) Use focus group methodology to identify barriers and enablers to the delivery of efficacious and cost-effective eye care that prevent vision loss and promote eye health in African Americans with diabetes; and 3) Implement telephone-based and educational interventions to improve DFE follow-up adherence in African Americans with diabetes utilizing a prospective cluster-based, randomized, cohort. The investigators at the WETRC will also participate in the design and implementation of a Collaborative TRC Network study, which aims to assure optimal two-way communication between the ophthalmologist and their patients' primary care physician (PCP). This Network study goals are to improve the ophthalmologists' patient education about blood sugar control by increasing the HA1C reporting from the PCP to the ophthalmologist. It also aims to improve PCP knowledge regarding their patients' severity of DR and recommended ocular follow-up. Successful achievement of the TRC-specific studies and the Collaborative TRC Network study will help to overcome barriers to obtaining ongoing DFEs and reduce disparities in vision care utilization. Our goal is to bring African Americans with diabetes closer to the Healthy People 2010 goal of 75% of all persons with diabetes having an annual DFE.